Access
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Jacksonville, TX
NPI 1013945898 · NPPES record last updated Jun 13, 2008
Key facts
- NPI
- 1013945898
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 45H269 (TX)
- Legal business name
- ACCESS
- Practice address
- 5656 N. Jackson
Jacksonville, TX 75766 - Phone
- (903) 589-9000
- Fax
- (903) 586-9200
- NPI assigned
- Jun 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Allyn Lang
- Title
- Executive Director
- Phone
- (903) 586-5507
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Anderson Cherokee Community Enrichment Services
Locations
5656 N Jackson St
Jacksonville, TX 75766
Phone (903) 589-9000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 45H269 | TX | Yes |
Addresses
Primary practice location
5656 N. Jackson
Jacksonville, TX 75766
Mailing address
5656 N. Jackson
Jacksonville, TX 75766
Phone (903) 589-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45H269 | Medicaid | TX |
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All providers in Jacksonville, TX · Intellectual Disabilities Intermediate Care Facility in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.